Americans have been fighting over health insurance reform for years. Single-payer proposals, as most recently proposed in California’s legislature, are just the latest example. However, while rhetoric has focused on how many would supposedly gain or lose insurance, wealth transfers have been the real issue. As economist Henry Aaron estimated a quarter-century ago, implementing comprehensive national health insurance would redistribute more income than any single public policy then in existence.

We know insurance is not the real issue because claimed “reforms” violate so many principles of insurance.

Insurance is about reducing risk from uncertain events. Insuring what would certainly occur, say, annual checkups, offers no risk reduction — no benefits to weigh against the added costs of insurance administration — yet such coverage is frequently mandated. Similarly, small health care risks are cheaper to cover with modest levels of savings than insurance. Absent government interventions, they would not be insured. People only want such insurance when others are forced to bear much of the cost.

The benefits from risk reduction would also have to outweigh the cost of over-consumption of health care induced by the artificially low prices insurance faces health care consumers with. However, when most health care costs are borne by third parties, there are many margins at which those individuals will want better care (e.g., better and more specialized doctors and hospitals, more costly newer drugs, tests and treatment, etc.) as well as more care, raising costs (or requiring rationed care). Much of that care will be worth far less than its cost to society.

Those considerations explain why there is no lunch insurance. You will almost certainly eat lunch, which involves relatively small expenses, so there would be little risk reduction. And if someone else paid most of your bill, you would order far more expensive lunches, raising the premiums you would be charged. The benefits don’t justify the costs, unless others are forced to pay. Similarly, teetotalers would not willingly insure for alcoholism treatment and those sure they would never use drugs would not insist on addiction treatment. Yet government “reforms” are full of such mandates.

The price controls reform proposals incorporate are also about transferring wealth, not health insurance. My age makes my actuarial risk six times that of my students. If, as Obamacare required, I could not be charged more than three times what they were, that really forces the young to subsidize the old, explaining why Obamacare imposed penalties to force acceptance of a bad deal.

Mandating coverage of pre-existing conditions also shows “reforms” are seldom really about insurance. It doesn’t reduce people’s risk exposure, it forces others to cover costs already known to be higher and deflects the blame to insurance companies who must charge others more. Such after-the-fact possibilities are not offered in fire, automobile or life insurance. Similarly, casinos don’t let you bet once the roulette ball or dice have stopped.

In addition, if health policy was truly aimed to benefit all Americans, rather than benefiting some by pick-pocketing others, it would not have been pushed with so many lies, damned lies and statistics. Honesty would have sufficed.

Our health insurance debate has become so contentious largely because it has allowed massive wealth transfers to be mis-represented as improving health insurance. It helped dishonestly sell Obamacare, and now portrays reducing massive theft from those government targeted to hold the bag as imposing heartless harm on others. Such mis-representation cannot generate policies that advance either Americans’ or Californians’ well-being.

Gary M. Galles is a professor of economics at Pepperdine University, an adjunct scholar at the Ludwig von Mises Institute, a research fellow of the Independent Institute, a member of the Foundation for Economic Education faculty network, and a member of the Board of Policy Advisors at the Heartland Institute. His books include Apostle of Peace (2013)Faulty Premises, Faulty Policies (2014) and Lines of Liberty (2016).